Agrawal Vineet, Byrd Benjamin F, Brittain Evan L
Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Pulm Circ. 2019 Feb 5;9(1):2045894019826043. doi: 10.1177/2045894019826043. eCollection 2019 Jan-Mar.
Heart failure due to diastolic dysfunction and pulmonary hypertension are frequent comorbid conditions with significant morbidity and mortality. Identifying the presence and etiology of diastolic dysfunction in the setting of pulmonary hypertension remains challenging despite profound therapeutic and prognostic implications. Additionally, there is little guidance in identifying and parsing etiology of diastolic dysfunction in patients found to have pulmonary hypertension. This review discusses the complex interplay between left ventricular diastolic dysfunction and pulmonary hypertension. With an explicit focus on the use of echocardiography for determination of diastolic dysfunction and etiology of pulmonary hypertension, this review also provides a comprehensive review of the literature and provides a framework by which to assess diastolic dysfunction echocardiographically in the setting of pulmonary hypertension.
舒张功能障碍所致心力衰竭和肺动脉高压是常见的合并症,具有显著的发病率和死亡率。尽管舒张功能障碍对治疗和预后有深远影响,但在肺动脉高压背景下识别其存在及病因仍具有挑战性。此外,对于已确诊肺动脉高压的患者,在识别和解析舒张功能障碍病因方面几乎没有指导意见。本综述讨论了左心室舒张功能障碍与肺动脉高压之间的复杂相互作用。本综述明确聚焦于使用超声心动图来确定舒张功能障碍及肺动脉高压的病因,还对相关文献进行了全面综述,并提供了一个在肺动脉高压背景下通过超声心动图评估舒张功能障碍的框架。